On Radio 4 this morning Chris Hopson (the chief executive of NHS Providers) said:
If the BMA doesn’t accept it, our members are saying to us that the secretary of state has to find a way to bring this to a conclusion. Three thousand operations being cancelled today: we can’t carry on like this. If the BMA won’t accept a fair and reasonable offer, then yes, it is legitimate and sensible for the secretary of state to consider imposition.
This really got my goat, because Radio 4 presented Chris Hopson as a neutral party in this dispute, a voice of reason with no axe to grind or agenda. But this is far from the case. Hopson, as CEO of NHS Providers, (an ‘membership organisation and trade association for the NHS acute, ambulance, community and mental health services that treat patients and service users in the NHS’), in part represents the private contractors to which billions in NHS services are farmed out.
Second, Hopson’s opposition to the British Medical Association (BMA) & the strike seems to be prefaced on painting them as militant – ‘…we can’t carry on like this’. Yet again this is far from the case. This is only the second strike since 1975. Think on that for a second. Since 1975, doctors have (as of the 10th February 2016) been on strike twice, the first time being on the 26th of January. That in itself can show you the extent to which the NHS & doctors are being strained & stretched under Jeremy Hunt’s tenure as Health Secretary. Britain in 2016 is not a nation held ransom by striking trade unions, the junior doctors striking today do not take this action lightly, no one striking does.
Rachel Clarke is a doctor in Oxford, she says: ‘Mr Hunt has made me feel demoralised, insulted and cheap. He implies we are the problem – well I give my life to the NHS. ‘It’s so grim on the frontline now, I sometimes work 14 or 15 hours straight without a second even to eat. I have never felt so despairing or so close to quitting medicine.’
Andy King, a registrar from Oxford, says: ‘With so many patients to see I am absolutely petrified, I’m too exhausted to look after them safely. ‘If we are stretched even more thinly over 7 days I’m certain patients are going to die.’
This is what they are saying. One final one, Jane Jenyon from Hereford says: ‘The profession is at absolute breaking point. I see doctors in tears because they are so despairing about what the future holds. Jeremy Hunt has done this. He is driving away a whole generation of doctors.
On the Andrew Marr show (Sunday 7th February 2016), when faced with testimony from junior doctors who had written in, Jeremy Hunt simply continued to lie through his teeth and blame the BMA. Hunt is not simply being pig-headed or ignorant in his stance, he is being deliberately unreasonable to induce a strike. Hunt wants to create an untenable situation, and conflict with the BMA & junior doctors to undermine the public support from the NHS. To use a quote attributed to Noam Chomsky:
That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital.
You can clearly see this in the manner in which Jeremy Hunt has conducted himself in this protracted dispute. Hunt is being deliberately uncompromising in intending to impose the proposed change to contracts (perfectly summed up here – the contract removes fundamental safeguard for the number of hours – tired doctors make mistakes & this increases risks. The contracts do not reduce the number of hours, without financial incentives or penalties those who design rotas will place doctors in a difficult position). Hunt does not want to negotiate, but accuses the BMA of not negotiating. Hunt either imposes the contracts, hitting the NHS, causing the it to haemorrhage doctors or he can paint junior doctors as ‘militant & unreasonable’, striking simply for money. Hunt is not willing to negotiate because he is playing ‘Russian Roulette’ with the NHS. He is taking the NHS on the path to privatization, because he wants to privatize it. Famously, he co-authored a book on this very subject (with everyones favourite UKIP MP Douglas Carswell).
The contracts dispute is designed to break the NHS. If Hunt imposes his contract on junior doctors, it dies a slow death. Junior doctors will be left with no option but to leave the UK (we already have a shortage of qualified doctors). Leaked NHS figures indicate that the number of young medics applying to continue their career in the health service by becoming specialists has plunged to a new low, appearing to support fears that the dispute will hit recruitment. Figures compiled by Health Education England (HEE) show that the number of Foundation Year 2 (F2) doctors who have applied to start training as a specialist in a branch of medicine next August in the NHS has fallen to just 15,855. That is 1,251 fewer than in 2013.
Young doctors will be left burnt out and demoralised, and bit by bit they will leave to work abroad to receive adequate conditions. BMA junior doctor committee chairman Dr Johann Malawana has stated:
Junior doctors already work around the clock, seven days a week, and they do so under their existing contract … If the government want more seven-day services then, quite simply, they need more doctors, nurses and diagnostic staff, and the extra investment needed to deliver it.
But under the Conservatives, these extra-funds will not be provided. So far however, Jeremy Hunt is not winning, despite the spin and a limited critique from an un-questioning media. A recent YouGov poll revealed that the public continues to back the strike and blames the government for failing to settle the dispute.
Junior doctors are particularly angry with Mr Hunt because of the way he has framed the debate as being about avoiding unnecessary deaths in hospitals over the weekend. This is a lie. On question time (15th January 2016) an audience member skewered Nick Boles (Conservative MP for Grantham and Stamford), alongside the ignorant character from a Wodehouse Novel Camilla Long (journalist of the Murdoch ‘The Times’) stating:
I want to point out to the public of this country that Jeremy Hunt and the government has systematically misled the entire country … People have actually died because of what Jeremy Hunt has said in Parliament about 11,000 deaths each year that he attributes to junior doctors. I am so sad that you have taken that on from this government. It is not true. The paper that he quoted from, he got the data from that paper a month before it came out. What he regarded as a weekend was a Friday, Saturday, Sunday, Monday. That is not a weekend. A weekend is Saturday and Sunday, is it not? He said people were dying on Saturdays and Sunday. If you look at that paper, on a Saturday and Sunday actually less people were dying.
To use an old maxim about lies – ‘if one is repeated often enough it becomes the truth‘. Regardless of the factual basis of Hunt’s assertions regarding weekend deaths, it has enabled him to paint the BMA & junior doctors as those in the wrong. Spun by a sympathetic media – it has given Hunt ammunition to keep the dispute going and attempt to incite public anger toward the BMA & thus the NHS.
Mr Hunt is an evasive liar. When faced with the prospect of questioning by Labour’s Shadow Health Secretary Heidi Alexander – Hunt did not appear (he had something else really important to attend….) Alexander’s questions were directed to Mr Hunt, but she and other MPs were met by junior health minister Ben Gummer.
Without giving an explanation for his superior’s absence, he said:
The Government are clear that our door remains open for further discussion, and we continue to urge the BMA to return to the table.
Heidi Alexander said Mr Hunt was ‘insulting the intelligence’ of junior doctors.
This is a group of people who are incredibly intelligent, are able to make their own minds up, have read the proposals for themselves and have followed the negotiations very carefully
Hunt et al are deliberately waging war on the NHS. If they can break the BMA & the junior doctors then the NHS will be on the road to inevitable privatisation. There are a finite number of junior doctors. If services are expanded then junior doctors will either have to work more hours to make this work or work more antisocial hours to cover the weekends and nights. The government will reclassify what is considered antisocial and stop monitoring exercises where trusts are financially penalised for working doctors to the point where patient safety is compromised. The best doctors need to be trained and retained. The point of the contracts Hunt will impose is to degrade this. Without concessions & the investment the NHS (already at breaking point) will collapse. Support the junior doctors, they support us when we are ill & at our weakest, it is only right we return the favour. They are on the front-line fighting for the NHS.
By Frederick Antonio Gallucci | International Law LLM | @gibblegbble